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期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-3225

摘要内容如下：

背景

运动被推荐为髋关节骨性关节炎（OA）患者的一线治疗。然而，缺乏为最佳运动类型提供证据的随机对照试验。

客观

研究渐进式抗阻训练（PRT）在改善髋关节OA患者的功能表现方面是否优于神经肌肉锻炼（NEMEX）。

设计

多中心、整群随机、对照、平行组、评估者盲法、优效性试验。（ClinicalTrials.gov：NCT04714047）

设置

医院和理疗诊所。

参与者

从2021年1月18日至2023年4月28日，160名临床诊断为髋关节OA的参与者被纳入研究，并被随机分配到PRT（n=82）或Nemex（n=78）。

干预

为期12周的PRT或NEMEX，每周有2次60分钟的监督小组会议。PRT干预包括5项针对髋关节和膝关节肌肉的高强度抗阻训练。NEMEX干预包括10个练习，强调感觉运动控制和功能稳定性。

测量

主要结果是30秒椅子站立测试（30s-CST）的变化。关键的次要结果是髋关节残疾和骨关节炎结果评分（HOOS）的疼痛和髋关节相关生活质量（QOL）分量表评分的变化。

结果

从基线到12周随访，30s-CST的平均变化为1.5（95%CI，0.9至2.1）个使用PRT的椅子架和1.5（CI，0.9至2.1）个使用Nemex的椅子架（差异，0.0[CI，-0.8至0.8]个椅子架）。对于HOOS疼痛分量表，PRT的平均变化为8.6（CI，5.3至11.8）分，Nemex的平均变化为9.3（CI，5.9至12.6）分（差异，-0.7[CI，-5.3至4.0]分）。对于HOOS QOL分量表，PRT的平均变化为8.0（CI，4.3至11.7）分，Nemex的平均变化为5.7（CI，1.9至9.5）分（差异，2.3[CI，-3.0至7.6]分）。

局限性

参与者和理疗师没有失明。

结论

在髋关节OA患者中，PRT在改善功能表现、髋关节疼痛或髋关节相关生活质量方面并不优于Nemex。

主要资金来源

丹麦独立研究基金。

英文原文如下：

Abstracts

BACKGROUND  Exercise is recommended as first-line treatment for patients with hip osteoarthritis (OA). However, randomized controlled trials providing evidence for the optimal exercise type are lacking.

OBJECTIVE  To investigate whether progressive resistance training (PRT) is superior to neuromuscular exercise (NEMEX) for improving functional performance in patients with hip OA.

DESIGN  Multicenter, cluster-randomized, controlled, parallel-group, assessor-blinded, superiority trial. (ClinicalTrials.gov: NCT04714047).

SETTING  Hospitals and physiotherapy clinics.

PARTICIPANTS  160 participants with clinically diagnosed hip OA were enrolled from 18 January 2021 to 28 April 2023 and randomly assigned to PRT (n = 82) or NEMEX (n = 78).

INTERVENTION  Twelve weeks of PRT or NEMEX with 2 supervised 60-minute group sessions each week. The PRT intervention consisted of 5 high-intensity resistance training exercises targeting muscles at the hip and knee joints. The NEMEX intervention included 10 exercises and emphasized sensorimotor control and functional stability.

MEASUREMENTS  The primary outcome was change in the 30-second chair stand test (30s-CST). Key secondary outcomes were changes in scores on the pain and hip-related quality of life (QoL) subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS).

RESULTS  The mean changes from baseline to 12-week follow-up in the 30s-CST were 1.5 (95% CI, 0.9 to 2.1) chair stands with PRT and 1.5 (CI, 0.9 to 2.1) chair stands with NEMEX (difference, 0.0 [CI, -0.8 to 0.8] chair stands). For the HOOS pain subscale, mean changes were 8.6 (CI, 5.3 to 11.8) points with PRT and 9.3 (CI, 5.9 to 12.6) points with NEMEX (difference, -0.7 [CI, -5.3 to 4.0] points). For the HOOS QoL subscale, mean changes were 8.0 (CI, 4.3 to 11.7) points with PRT and 5.7 (CI, 1.9 to 9.5) points with NEMEX (difference, 2.3 [CI, -3.0 to 7.6] points).

LIMITATION  Participants and physiotherapists were not blinded.

CONCLUSION  In patients with hip OA, PRT is not superior to NEMEX for improving functional performance, hip pain, or hip-related QoL.

PRIMARY FUNDING SOURCE  Independent Research Fund Denmark.

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